Hand brace

ABSTRACT

A hand brace providing controlled individual flexion, extension, adduction and abduction tension of the digits particularly though not exclusively suited for post-operative use during formation of the fibrous joint capsule following metacarpophalangeal and proximal interphalangeal joint implant arthroplasty and the like, includes a longitudinal member adapted to overlie the forearm and be releasably secured thereto and having a stabilizing pad for juxtaposition on the flat dorsal area of the ulna and radius just above the carpus with the proximal end terminating just short of the elbow and the distal end overhanging the hand and having means for engaging and positioning the metacarpophalangeal area and further adjustably supporting a transverse member in spaced relation above and/or below the hand which adjustably carries digit slings for effecting the flexion and/or extension movement of the digits. The slings are connected to the frame means by connectors permitting quick and simple adjustment by the surgeon and one hand adjustment by the patient. In addition to or in lieu of the slings, pressure pads may be mounted to engage the phalanges to position them as required. The brace may be folded flat for shipping or storage.

United States Patent Palmer 5] Feb. 6, 1973 HAND BRACE [76] Inventor: Robert M. Palmer, 20099 W. Bal- FOREIGN PATENTS OR APPLICATIONS OTHER PUBLICATIONS The Swanson Post-Operative Hand Splint Pope Brace Co. Brochure urposeful Splinting Following Injuries of the Hand by Koch et a1. Surgery, Gynecology and Obstetrics,

Jan. 1939, Vol.68, page 13, Fig. 15.

Granberrys Metacarpal and Phalanges Splint DePoy Fracture Catalogue, 1943, page 18.

Primary ExaminerRichard A. Gaudet Assistant Examiner-J. Yasko Attorney-Burton & Parker [57] ABSTRACT A hand brace providing controlled individual flexion, extension, adduction and abduction tension of the digits particularly though not exclusively suited for post-operative use during formation of the fibrous joint capsule following metacarpophalangeal and proximal interphalangeal joint implant arthroplasty and the like, includes a longitudinal member adapted to overlie the forearm and be releasably secured thereto and having a stabilizing pad for juxtaposition on the flat dorsal area of the ulna and radius just .above the carpus with the proximal end terminating just short of the elbow and the distal end overhanging the hand and having means for engaging and positioning the metacarpophalangeal area and further adjustably supporting a transverse member in spaced relation above and/or below the hand which adjustably carries digit slings for effecting the flexion and/or extension movement of the digits. The slings are connected to the frame means by connectors permitting quick and simple adjustment by the surgeon and one hand adjustment by the patient. In addition to or in lieu of the slings, pressure pads may be mounted to engage the phalanges to position them as'required. The brace may be folded flat for shipping or storage.

5 Claims, 18 Drawing Figures PATENTEDFEB ems 3,714,940 SHEET 10F 5 INVENTOR. R0517??? P/M/Mffi 2M, 5 WM ATTORNEYS PATENTED EB 6191s 3.714340 SHEET 20F 5 9a /04 FF 4 0? my JO 1. m2

IINVENTOR.

Kelsi/er m'. PAZ/Hffi BY 6% & Pmiuu ATTORNEYS PATENTEDFEB 6 ma 'snmuor 5' 3,714,940

72! mo, 22 I INVENTOR Razz/er M. 544/145? ATTORNEYS PATENTED FEB 6 I975 SHEET 50F 5 Fl (3. l8

Fl G. l'7

ATTORNEYS HAND BRACE FIELD OF THE INVENTION This invention relates to a brace to be secured to the forearm for effecting flexion and/or extension of the digits of the hand and is particularly though not exclusively adapted for use during the post operative periods following metacarpophalangeal and proximal interphalangeal joint implant arthroplasty. Such arthroplasty is briefly described in the publication entitled Armam entarium, Volume V, number 5, pages 1-3, published by V. Mueller, 6600 W. Touchy Ave.,- Chicago, Illinois.

BACKGROUND OF THE INVENTION Recently there has been developed surgical techniques utilizing joint prostheses for restoring function to hands disabled by rheumatoid arthritis or trauma. Briefly the arthroplasty comprises the removal of the defective joint by severing the bones on both sides thereof, forming intermedullary sockets in the severed ends and inserting in the sockets stems of the artificial joint. During healing and formation of the fibrous capsule about the joint it is necessary to alternately bend and straighten the joint in such a way as to insure proper range of movement and good radial tightness of the capsule to prevent any tendency toward ulnar deviation and provide stability during pinching movements. For this purpose a brace is mounted on the arm for engaging the fingers and subjecting them to flexion and extension. One such brace is shown in the aforesaid Armamentarium publication.

Such prior art brace has a number of drawbacks among which are that it is painful for some patients to wear; it is difficult in some cases to adjust to the patients arm for a proper fit; it is not interchangeable from one arm to the other; flexion is accomplished by utilizing a cuf which does not allow individual digit flexion adjustment or momentary extension; it is not sufficiently rotationally stable; the patient cannot adjust finger tension with one hand while wearing it on the other hand and finger adjustment is even time-consuming by the surgeon using both hands.

While the prior art shows a number of braces as disclosed by the following US. Pats., none of them provide individual finger flexion and extension and interchangeability between hands, and have other draw-v backs as well:

Nos. 2,553,277; 2,312,523; 2,438,144; 2,767,708; 3,526,006.

An object of my invention is the provision of a lightweight brace which is readily mountable and demountable from the arm, is rotationally and skew stable on the arm, and provides individual flexion and/or extension of the fingers and individual adjustment thereof and of abduction or adduction during either flexion or extension.

Another object of the invention is the provision of a brace as aforesaid which is interchangeable from one hand to the other.

Another object of the invention is the provision of a brace as aforesaid which is readily adjusted by the surgeon to properly fit the forearm and metacarpalphalangeal area of the hand so that the brace is not only properly supported on the arm with the wrist in the desired alignment, but also the proper dorsal reaction is provided for the metacarpal-phalangeal joint area as well as alignment of such area in predetermined relation with the forearm axis during finger extension and flexion. A concomitant object is the provision of such a brace which allows the surgeon to quickly and easily adjust both the angle of tension and amount thereof imposed on the phalanges in flexion and/or extension.

Another object of the invention is the provision of a brace as aforesaid which allows the patient to adjust the angle and finger tension with one hand while it is worn on the other hand.

Another object of the invention is the provision of such a brace which may be folded flat for shipment or storage.

A number of the foregoing objects are attained by my improved brace disclosed herein based on my discovery that to stabilize the brace in relation to the hand, which is necessary for good flexion and/or tension control of the digits, the brace cannot be simply designed to overlie the dorsal side of the forearm and be tightly secured thereto, as in the prior art, but rather must be designed to take advantage of anatomically existing surfaces which can function aslocating and stabilizing planes and at the same time the design must minimize the influence of movement by other anatomical surfaces which would reduce the effectiveness of the chosen surfaces in providing, locating and stabilizing planes. When, as in the prior art, the brace is simply clamped or secured to the forearm along the dorsal side, rotation of the arm causes a relative revolution of the radius and ulna and a circumferential shifting of the muscles, which disturb the stability and give rise to unwanted shifting of the brace relative to the hand. Also, in an effort to provide stability, the amount of padding or cushioning between the brace and forearm is reduced and the brace tightly clamped to the forearm. This gives rise to patient discomfort and consequent slower healing or development of the fibrous capsule about the digit joints.

In my brace I provide a stabilization pad or bracket sized to embrace the forearm and having a flat or planar portion corresponding in width to and adapted to be juxtaposed on the flat dorsal surface of the forearm proximally adjacent the head of the ulna. This pad serves to rotationally stabilize the brace on the forearm in determined rotational relation to the hand. A second pad is provided spaced upwardly along the forearm from the first pad and is sized to embrace the dorsal side of the forearm distally adjacent the elbow but spaced from the upper arm when the elbow is bent. The brace has a longitudinal frame portion which is secured to the upper sides of the pads in spaced relation from the remainder of the forearm, and releasable straps secure the pads in place. As a result only two localized areas of contact between the brace and forearm are provided, and both good rotational and skew stability are thereby provided with a minimum of interference by revolution of the ulna and radius or flexing or shifting of the arm muscles.

Further unique characteristics of my brace, other objects, advantages, and meritorious features will more fully appear from the following specification, claims,

and drawings, wherein:

FIG. 1 is a side elevation of a preferred form of the hand brace showing it mounted in the intended position on the forearm and in operable relation to the hand;

FIG. 2 is a plan view of the brace in relation to a human hand and forearm;

FIG. 3 is a front elevation looking in the direction of arrow 3 of FIG. 1 but with the representation of the human'hand, the protective bumper and the-metacarbut with the lower or volar transverse member swung forwardly to provide a support for a different form of digit flexion;

FIG. 8 is a side elevation of a modified form of the hand brace wherein a number of the parts correspond to those shown in the brace of FIG. 1;

FIG. 9 is a plan view of the brace shown in FIG. 8;

FIG. 10 is a side elevation of the brace shown in FIG. 8 with a volar bracket attachment providing a fulcrum at the interphalangeal joints;

- FIG. 11 is across-sectional view through a digit sling slider taken on the line 11-11 of FIGS. 2 and 9;

FIG. 12 is a cross-sectional view but with parts removed for clarity taken on the line 12-12 of FIG. 9;

FIG. 13 is a'view of the proximal end of the brace taken on the line 13-13 of FIGS. 1 and 8;

FIG. 14 is a cross-sectional view taken on the line 14-14 of FIGS. 1 and 8;

FIG. 15 is a cross-sectional view taken on the line 15-15 of FIGS. 1 and 8;

FIG. 16 is a fragmentary plan view of a modified form of the brace;

FIG. 17 is a cross-sectional view taken on the line 17-17 of FIG. 16; and

FIG. 18 is a perspective view of the volar attachment shown in FIG. 10.

7 DESCRIPTION OF PREFERRED EMBODIMENTS A preferred embodiment of the invention is disclosed in FIGS. 1-3 as including a frame 20 having a digit sling-carrying member 22 arranged to extend transversely of the hand H in spaced relation thereto, and a longitudinally extending member 24 connected to the digit sling-carrying member 22 and extending along the forearm F. Means are provided for supporting and preventing rotation and skewing of said members relative to. the hand. Such means comprise a pair of inverted generally U-shaped brackets 26 and 28 sized to closely fit the forearm (see FIGS. 13 and 14) with the bight portion of each overlying the dorsum D of the forearm. Bracket 28, which may be termed the proximal bracket, is disposed adjacent the distal side of the elbow (not shown) spaced slightly from the' upper arm when the elbow is bent so as not to interfere with the upper arm and cause discomfort for the patient. The other bracket 26, which may be termed the distal bracket, is disposed proximally adjacent the head of the ulna. The longitudinal member 24 is secured in any suitable fashion to the outside of the bight portion of the brackets, as by rivets 27 and 29.

The inside of each of the brackets is covered by a thin foam rubber or the like padding 30 and 32 which may be glued thereto. The brackets are provided with releasable straps 33 and 34, one end of which 35 is secured to the bracket as by gluing, or the like, and is provided with one part 36 ofa releasable fastener, such as the hook portion of a Velcro hook-and-pile fastener, and the other end 37 of each strap is provided with the pile part of such fastener. The straps encircle the volar part of the forearm beneath the brackets to secure the longitudinal member to the forearm with the brackets in the aforementioned positions. The brackets are mounted as far apart along the longitudinal member as possible with the proximal bracket 28 disposed in relation to the elbow and forearm as aforesaid.

The brackets are shaped in cross-section to conform to the shape of that portion of the forearm embraced thereby. In the case of the distal bracket 26, the inside of the bight portion, as indicated at 38 in FIG. 14, is generally planar or flat and coextensive in width with the flat dorsum D' of the forearm proximally adjacent the carpus C and head of the ulna U and is adapted to be juxtaposed thereupon as shown particularly in FIGS. 1, 2 and 14. This flat dorsal area D of the forearm provides a natural anatomical locating plane for stabilizing the brace against rotation and for maintaining it in predetermined relation with the hand.

It will be noted from FIGS. 13 and 14 that with the longitudinal member 24 secured to the outside of the bight portion of the brackets 26 and 28, such member is spaced above the dorsal side of the forearm so that the only mounting or contact points between the forearm and the longitudinal member 24 are provided by the brackets and as a consequence movement of the surface of the forearm as by twisting thereof has a minimal influence on the rotational stability of the brace afforded by the flat dorsal area proximally adjacent the carpus and head of the ulna.

The longitudinal member 24 extends forwardly over the metacarpal and metacarpophalangeal area of a hand as best shown in FIGS. 1 and 2 and is disposed in spaced relation above the dorsal side thereof. In FIG. 1 the longitudinal member is shown as having an upwardly stepped portion 40 which projects in the aforesaid relation over the metacarpal and metacarpophalangeal area. Secured to the upwardly stepped portion 40 of the longitudinal member is a metacarpophalangeal pad in the form of an inverted generally U-shaped bracket 42 best shown in FIG. 15. The inside of such bracket is provided with foam rubber padding or the like 44 for bearing engagement against the dorsal and lateral surfaces of the metacarpophalangeal area as shown, and the bracket with such padding is sized to closely embrace such portion of the hand. A releasable strap 46 may be secured to the bracket and provided with any suitable fastener, such as the hook-and-pile Velcro fastener described in connection wit the straps 33 and 34. A volar pad 47 of soft cushion-like material may be mounted on the strap 46 to underlie the volar area of the hand. The strap 16 and pad 47 serve to hold the metacarpophalangeal portion of the hand upwardly within the bracket in predetermined relation with the carpus and forearm as determined by the longitudinal member 24, and provide a reaction point for the digits during flexion or extension as may be seen in FIG. 1. Further positioning of the metacarpophalangeal area is provided by a longitudinal slot 48 in the upwardly stepped portion 40 of the longitudinal member,

through which a screw 49 or the like extends having a head overlying the upper surface of portion 40 and with the shank of the screw threadedly connected with the bight portion of the bracket 42. As a consequence of this means of securing the bracket to the upwardly stepped portion 40, the bracket may be adjustably positioned along the slot as desired by the physician, and the bracket may be swung about the pivotal axis formed by the screw 49 to any desired askew position and locked in such position by tightening the screw.

The transverse member 22 in the embodiment shown comprises the bight portion of a generally U-shaped frame 23 having arms 22' and 22". The distal ends of such arms are connected for adjustable swingable movement to a transversely extending supporting means comprising a support member 50 connected to the upwardly stepped portion 40 by a slider 51 shown in FIGS. 2, 5 and 6. Opposite ends of the member 50 may be upturned and screw fasteners or the like 52 extending through the distal ends of the arms are threadedly connected with such upturned ends of the member 50 and by tightening and loosening such screw members the transverse member 22 may be swingably positioned above the hand or swung back to the position shown in FIG. 4 for storage or shipment. The slider 51 comprises a U-shaped channel having a bottom wall 54 and parallel opposed side walls 56 and 58. A longitudinal member receiving slot 60 is cut through the bottom wall 54 and extends along the inner face of the side wall 56. A screw threaded element 62 is threaded through the wall 58 to bear against the transverse supporting member 50. The depth of the slot 60 in the side wall 56, i.e., at 64, is less than the thickness of the longitudinal portion 40 such that upon tightening the screw 62 against the member 50, the longitudinal portion 40 and supporting member 50 will be tightly clamped together as shown in FIG. 5. It will be noted that the slider will allow positioning of the member 50 longitudinally along the longitudinal member 24 on the portion 40 thereof and will also permit lateral adjustment of the member 50 on the longitudinal member and locking of thetwo members in desired relative positions, and that such adjustment will effect a lateral and longitudinal shifting of the transverse member 22 with respect to the hand.

One or more digit slings are adjustably connected to the transverse member 22. The slings may be adjusted along the length of the transverse member and their distance from the member may also be independently adjusted to provide individual digit tension. Two types of such slings are disclosed herein. The first type, indicated at 66, is suitable for either extension or flexion while the other type 67, is suited only for flexion. The first type sling 66 comprises a flexible loop of any suitable material and a digit to be tensioned is inserted within the loop as shown. Connected to the loop is a cord 68 which extends through a slider 70 mounted on and slidable along the transverse member 22. The slider 70 is shown in FIG. 11. It is generally U-shaped in cross-section having opposed side walls 72 and 74 connected by a bight portion 76. The side wall 74 is provided with a lip 78 such that the bight portion and lip 78 prevent unintentional dislodgment of the slider from the transverse member 22. The lip and bight portions are provided with cord-receiving apertures 80 and 82 through which the cord 68 extends. In addition, a screw thread element 84 is threaded in the side wall 72 and bears against the transverse member 22. It will be noted that the cord 68 extends beneath the transverse member 22 between it and the side wall 74 of the slider,

such that upon tightening screw 84 to squeeze member 22 against wall 74 to lock the slider in transverse posi tion on member 22, the cord 68 will also be gripped and locked in adjusted. position. If desired a knurled head may be provided on the screw 84 which may be grasped by the fingers for ease of adjustment of the slider and/or cord with just one hand. A screwdriver slot may be also provided for more permanent tighten- If desired a portion of the cord 68 intermediate the sling 66 and slider 70 may be of elastic material as at 86 in FIG. 1, which elastic material is connected at one end to the sling and at the opposite end to the cord portion extending through the slider. The elastic portion may comprise an elastic band or any other suitable element.

If desired the arms 22 and 22" may be provided with apertures 88 for adjustable attachment to the ends of transverse support member 50- and/or for attachment of a protective bumper 90 of generally U- shaped configuration having arm portions 92 and 94 connected by a bight portion 96 with thearms and bight portions disposed laterally and distally of the hand to protect the same from accidental bumping and v the painful consequences thereof. The bumper may be secured by any suitable fasteners 98 extending through the distal ends of the arms 92 and 94 and selected apertures 88 in the arms 22' and 22".

As thus described the slings 66 will provide for extension of the digits. Flexion of the digits is provided by a second transverse member 100 which is disposed below and extends transversely of the hand and is adjustably mounted on the longitudinal member 24. Member 100 is the bight portion of a U-shaped frame 101 similar to frame 23, and having arms 100' and 100" connected at their distal ends by screw fasteners or the like 102 to opposite downturned ends of transverse supporting means comprising a member 104 connected to the upstepped portion 40 of the longitudinal member 24 by a slider 106 of the same construction as slider 51, but inverted on the portion 40. Member 100 may be swingably, laterally, and longitudinally adjusted between desired positions such as those shown in FIGS. 1, 4 and 7.

One or more sliders may be mounted on member and slings similar to slings 66 connected thereto, somewhat like the arrangement shown in FIG. 10 to provide flexion; or slings 67 swung between members 22 and 100 as shown in FIG. 1, may be utilized as desired. Sling 67 comprises a length of relatively stiff but malleable material bent at 110 to an angle to cradle a digit as shown. The sling includes two pairs of upstanding digit embracing flaps 112 and 114 and may be internally padded as at 116. Opposite ends of the sling are connected by cords 118 and 120 to sliders 70 on members 22 and 100 whereby the position of the sling may be adjusted as desired.

In FIG. 7 a different form of digit flexion means is provided comprising a pad 122 of relatively rigid material bent at an obtuse angle and provided with padding 124. A boss 126 on the pad has a screw member 128 secured thereto and threadedly engaged in a slider 130 mounted on transverse'member 100 and adjustably secured thereto by a screw member 132 threaded to the slider and bearing against member 100. By adjusting screw member 128 to shift pad 122 toward and away from the digit cradled therein adjustable flexion positioning of the digit may be attained. A lock nut 131 may be provided for maintaining the pad-122 in fixed position.

A somewhat modified form of the hand brace is shown in FIGS. 8, 9 and 12. To the extent this form of the brace corresponds to the form heretofore described, commonreference numerals are utilized. The spacing of the proximal bracket 28 from the upper arm UA on the distal side of the elbow (not shown) is illustrated in FIG. 8 and such spacing is also applicable to the FIG. 1 ,embodiment. The principal difference between the embodiments is in the means by which the transverse members 22 and 100 are carried by the longitudinal member 24. The longitudinal member 24 has an upwardly stepped portion 134 which extends over the carpus and dorsal side of the hand rising through a second stepped portion 136 to a forwardly projecting elevated section 138 to which member 22 is secured for transverse and longitudinal adjustment by a slider 140. Slider 140 is U-shaped in cross-section as shown in FIG. 12 with the arms 142 being slotted to slidably receive the member 22. A screw member 144' threaded through the bight of the U-shape bears against member 22to adjustably lock member 22 to section 1380f longitudinal member 24. Sling sliders 70 may be slidably adjustably mounted on member 22 to carry slings '66. From FIG. 12 it will be noted that radial tension as well as extension may be imposed on digits received in the slings. Such tensioning is also capable with the brace of FIG. 1.

To the distal ends of the arms 22 and 22" are secured the distal ends of the arms 100' and 100" of the transverse member 100. In FIG. 8 member 100 is shown in solid outline as extending rearwardly to permit flexion of the digits as shown in FIG. by slings 66. Phantom outline vertically downwardly extending adjusted positions for member 100 are indicated at 100-A and 100-B in FIG. 12 which may be desired where member 100 is to be utilized as a rest or support for the brace or for any other purpose desired by the physician. Equidistant hole spacing of apertures 88 in the arms of members 22 and 100 allow for such vertical adjustment.

To'permit longitudinal and skew adjustment of the metacarpophalangeal pad in the brace of FIGS. 8, 9 and 12, the pad bracket 42 is provided with a rearwardly extending mounting member 146 which is longitudinally slottedas at 148 (see FIG. 9), and the upwardly stepped portion 134 is provided with an aperture through which extends a fastener 150 for locking the pad and longitudinal member in longitudinally and laterally adjusted positions. In FIG. 15, the portion 24 indicated would correspond to the member 146 in FIG. 8.

Means are also provided for tensioning the thumb as shown in FIG. 9. Such comprises a bracket 1S2 connected at opposite ends to the member 100 and its arm 100' across the angle therebetween and a slider 70 may be mounted thereon to carry a sling 66 and a connecting cord. A similar bracket and sling arrangement may be utilized for the brace of FIG. 1 to provide for thumb tensioning.

In FIG. 16 I have shown a modification of the longitudinal member for longitudinal adjustment of the distance between the distal and proximal brackets, and for width adjustment of the distal bracket. Such features would be desirable where there was a desire to stock a standard size hand brace rather than have each brace made to an individual patients measurements. Such features, it will be appreciated, may be applied to the braces of either FIGS. 1 or 8. The longitudinal member is comprised of two longitudinally adjustable sections 24-A and 24-3, one or both of which may be slotted as at 154 with a pair of threaded fasteners 156 extending therethrough to lock the members 24-A and 24-8 in adjusted longitudinal positions such that the brackets 26 and 28 may be positioned on a patients forearm as previously described. By forming bracket 28 of a relatively rigid but deformable material it may be bent slightly open or closed to closely embrace the forearm. Bracket 26, on the other hand, is formed of two L-shaped sections 26-A and 26-8 having their longer ends slotted as at 158, and overlapped, with a threaded fastener 160 extending through the slots and threadedly connected to section 24-B. Within the bracket a dorsal bight portion comprises a plate 162 secured as by rivets 164 to the longitudinal section 24-8 with the surface opposed to the forearm covered by a sponge rubber or the like cushion 166. Lateral cushions 168 are secured to the depending arm portions of bracket section 26-A and 26-8 to abut the lateral sides of the forearm. A suitable strap 170 and cushion 172 may be secured to the bracket similar to the straps heretofore described. By slidably,adjusting bracket sections 26-A and 26-8 relative to each other the bracket may be adjusted to the width of the flat dorsal surface of the forearm at the region proximally adjacent the carpus and head of the ulna.

FIGS. 10 and 18 disclose a volar metacarpophalangeal pad usable with the brace of FIG. 8, and with modification which will be apparent to those skilled in the art could be adapted to the brace of FIG. 1. The pad includes a generally U-shaped element 174 having a flange 176 which may be secured by bolts 178 or the like to the top surface of the portion 1340f longitudinal member 24. The other flange 180 is provided with a pair of fasteners 182 extending through a slot 184 in a longitudinally extending arm 186 to the distal end of which is secured a pad element 188 having a series of interphalangeal stepped surfaces 190, 192, 194 and 196 formed by cylindrical elements slotted and secured over the stepped edge of the arm as shown. The surfaces -196 underlie-the interphalangeal joints as shown in FIG. 10 to form fulcrums at such joints for the digits in flexion.

While the brace, as above described, may be formed of any suitable material, I have found that aluminum is particularly satisfactory as it is light in weight and varieties are available which allows the various parts to be bent and formed to the shapes shown. The sliders may be formed of more rigid aluminum to resist the compressive forces imposed on them.

The braces disclosed herein can be worn on either arm such that following use in connection with one hand, the brace may be adjusted for use with the other hand, thereby saving the patient the expense of acquiring a second brace. The embodiment of FIG. 1 may, in

some instances, be preferable over that of FIG. 8 as it can be collapsed for shipment or storage while remaining assembled.

It has been heretofore mentioned that the cord 68 supporting the sling 66 may include an elastic portion 86. Such elastic portion of the cord will facilitate placement of the sling on the digit as well as removal therefrom without the necessity of disturbing adjustment of the slider 70. In addition, the elastic portion will allow the patient to flex the digit while it is held by the sling. If desired the cords 118 and 120 supporting the sling 67 may also include elastic portions.

While I have shown the sliders 70 mounted on the transverse members 22 and 100 of the FIG. 1 embodiment, it is to be understood that similar sliders may be mounted on the leg portions 22' and 22", and 100' and 100" to permit a greater degree of abduction or adduction than is possible with the' adjustments afforded by the mounting on members 22 and 100.

What is claimed is:

1. A hand brace for providing controlled individual digit tension comprising, in combination:

a frame having a longitudinal portion adapted to extend along and overlie the dorsum of the forearm and metacarpal area of the hand and a transverse digit sling-carrying portion extending transversely of the longitudinal portion and adapted to be disposed in spaced relation from the hand,

said longitudinal frame portion including a pair of inverted generally U-shaped rigid brackets disposed in spaced apart relation therealong and adapted to closely embrace the forearm and support the longitudinal portion of the frame in spaced relation above the dorsum of the forearm and metacarpal area of the hand such that such brackets provide the sole support of the longitudinal frame portion on the arm,

one of said brackets adapted to be disposed at the each slingrand a locking slder on the transverse portion of the frame engaging each cord and adjusting its length and position along such transverse portion of the frame, said locking slider comprises a part slidably embracing said transverse portion of the frame,

locking means mounted on the slider for reaction against said transverse portion of the frame to lock the slider thereon at adjusted positions therealong, and said suspending cord for the sling extending through said part and across the transverse portion of the frame to be gripped in adjusted positions thereagainst upon reaction of said locking means against said portion to lock the slider thereon. 2. The invention defined in claim 1 characterized in that bumper means are provided secured to the frame and having a portion projecting beyond the distal end of the digits to prevent accidental bumping thereof.

3. The invention defined by claim 1 further characterized in that said cord extends across the transverse portion of the frame between it and a confronting surface of the slider which is urged against said portion of the frame to grip the cord upon reaction of the locking means to lock the slider in adjusted position.

4. The invention defined by claim 3 characterized in that said locking means comprises a screw member threadedly engaging said part and extending perpendicularly toward said transverse portion of the frame to abut the same and having a head portion disposed outwardly of the slider for manual rotation.

5. The invention defined by claim 1 characterized in that two such transverse digit sling-carrying frame portions are provided secured to the longitudinal member such that one is adapted to be located above and the other below the hand for effecting both flexion and extension of the digits. 

1. A hand brace for providing controlled individual digit tension comprising, in combination: a frame having a longitudinal portion adapted to extend along and overlie the dorsum of the forearm and metacarpal area of the hand and a transverse digit sling-carrying portion extending transversely of the longitudinal portion and adapted to be disposed in spaced relation from the hand, said longitudinal frame portion including a pair of inverted generally U-shaped rigid brackets disposed in spaced apart relation therealong and adapted to closely embrace the forearm and support the longitudinal portion of the frame in spaced relation above the dorsum of the forearm and metacarpal area of the hand such that such brackets provide the sole support of the longitudinal frame portion on the arm, one of said brackets adapted to be disposed at the proximal end of the forearm adjacent the elbow to prevent skewing of the brace, the other bracket adapted to be disposed at the distal end of the forearm and having a flat inside bight portion coextensive in width with the flat dorsum area of the forearm proximally adjacent the carpus and head of the ulna for juxtaposition on such flat dorsum to prevent rotation of the brace relative to the hand, said longitudinal portion of the frame including a third inverted generally U-shaped bracket disposed distally from the second mentioned bracket and adapted to closely embrace the dorsal metacarpophalangeal area of the hand and position the dorsal metacarpal area in determined spaced relation beneath the longitudinal portion of the frame, releasable strap means at each bracket adapted to circle beneaTh the forearm and hand to secure each bracket to the forearm and hand as aforesaid, a sling for each digit to be tensioned, a suspending cord secured at the end of each sling for each sling, and a locking slider on the transverse portion of the frame engaging each cord and adjusting its length and position along such transverse portion of the frame, said locking slider comprises a part slidably embracing said transverse portion of the frame, locking means mounted on the slider for reaction against said transverse portion of the frame to lock the slider thereon at adjusted positions therealong, and said suspending cord for the sling extending through said part and across the transverse portion of the frame to be gripped in adjusted positions thereagainst upon reaction of said locking means against said portion to lock the slider thereon.
 1. A hand brace for providing controlled individual digit tension comprising, in combination: a frame having a longitudinal portion adapted to extend along and overlie the dorsum of the forearm and metacarpal area of the hand and a transverse digit sling-carrying portion extending transversely of the longitudinal portion and adapted to be disposed in spaced relation from the hand, said longitudinal frame portion including a pair of inverted generally U-shaped rigid brackets disposed in spaced apart relation therealong and adapted to closely embrace the forearm and support the longitudinal portion of the frame in spaced relation above the dorsum of the forearm and metacarpal area of the hand such that such brackets provide the sole support of the longitudinal frame portion on the arm, one of said brackets adapted to be disposed at the proximal end of the forearm adjacent the elbow to prevent skewing of the brace, the other bracket adapted to be disposed at the distal end of the forearm and having a flat inside bight portion coextensive in width with the flat dorsum area of the forearm proximally adjacent the carpus and head of the ulna for juxtaposition on such flat dorsum to prevent rotation of the brace relative to the hand, said longitudinal portion of the frame including a third inverted generally U-shaped bracket disposed distally from the second mentioned bracket and adapted to closely embrace the dorsal metacarpophalangeal area of the hand and position the dorsal metacarpal area in determined spaced relation beneath the longitudinal portion of the frame, releasable strap means at each bracket adapted to circle beneaTh the forearm and hand to secure each bracket to the forearm and hand as aforesaid, a sling for each digit to be tensioned, a suspending cord secured at the end of each sling for each sling, and a locking slider on the transverse portion of the frame engaging each cord and adjusting its length and position along such transverse portion of the frame, said locking slider comprises a part slidably embracing said transverse portion of the frame, locking means mounted on the slider for reaction against said transverse portion of the frame to lock the slider thereon at adjusted positions therealong, and said suspending cord for the sling extending through said part and across the transverse portion of the frame to be gripped in adjusted positions thereagainst upon reaction of said locking means against said portion to lock the slider thereon.
 2. The invention defined in claim 1 characterized in that bumper means are provided secured to the frame and having a portion projecting beyond the distal end of the digits to prevent accidental bumping thereof.
 3. The invention defined by claim 1 further characterized in that said cord extends across the transverse portion of the frame between it and a confronting surface of the slider which is urged against said portion of the frame to grip the cord upon reaction of the locking means to lock the slider in adjusted position.
 4. The invention defined by claim 3 characterized in that said locking means comprises a screw member threadedly engaging said part and extending perpendicularly toward said transverse portion of the frame to abut the same and having a head portion disposed outwardly of the slider for manual rotation. 